Why the study?
Diagnosis and management of low-flow/low-gradient aortic stenosis are challenging because resting echocardiography cannot differentiate between different types and origins, making DSE and CCT necessary.
Does transcatheter aortic valve implantation improve symptoms and hemodynamics in patients with low-flow/low-gradient aortic stenosis lacking contractile reserve?
Case Report (n=1)
No
Does transcatheter aortic valve implantation improve symptoms and hemodynamics in patients with low-flow/low-gradient aortic stenosis lacking contractile reserve?
Demonstrates the critical role of dobutamine stress echocardiography and cardiac CT in evaluating severe LF/LGAS without contractile reserve, showing that TAVI can successfully yield symptomatic and hemodynamic improvement.
TAVI may relieve symptoms in low-flow/low-gradient AS without contractile reserve; hypothesis-generating and requires prospective validation before broader adoption.
Background: Diagnosis and management of low-flow/low-gradient aortic stenosis are very challenging. Resting echocardiography is not capable of differentiating between different types and origins of low-flow and low-gradient state in aortic valve stenosis. Therefore, dobutamine stress echocardiography (DSE) and cardiac computed tomography (CCT) are necessary. This case report should illustrate the importance of these assessments. Case summary: A 73-year-old woman presented to our emergency department with New York Heart Association III symptoms of exertional dyspnoea. In addition, the patient complained of fatigue and low resilience. On physical examination, auscultation revealed a systolic murmur over the aortic valve. Further diagnostic steps revealed a low-flow/low-gradient aortic valve stenosis (LF/LGAS) without contractile reserve (CR) in DSE and massive valve calcification in CCT. Discussion: In this case, we demonstrate the importance of different assessments and workflow. The prognosis of LF/LGAS has been re-evaluated during the last decade and the current guidelines recommend the treatment of such patients even in the absence of CR. Furthermore, we are discussing the results of LF/LGAS.
No takes yet. Share an insight, caveat, or question.
Stastny et al. (2022) conducted a case report in Low-flow/low-gradient aortic stenosis without contractile reserve (n=1). Transcatheter aortic valve implantation (TAVI) was evaluated on Clinical symptoms and prosthetic valve function at 6 months.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: